Robin Gelburd, JD, is the President of FAIR Health, a national, independent nonprofit organization with the mission of bringing transparency to healthcare costs and health insurance information. FAIR Health possesses the nation’s largest collection of private healthcare claims data, which includes over 31 billion claim records contributed by payers and administrators who insure or process claims for private insurance plans covering more than 150 million individuals. Certified by CMS as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D; FAIR Health houses data on Medicare Advantage enrollees in its private claims data repository. Gelburd is a nationally recognized expert on healthcare policy, data and transparency.
COVID-19 created a striking rise in telehealth services over the past year, as seen in claims tracked by FAIR Health.
Telehealth claim lines increased 2980% nationally from September 2019 to September 2020, rising from 0.16% of medical claim lines in September 2019 to 5.07% in September 2020, according to new data from FAIR Health’s Monthly Telehealth Regional Tracker (Figure 1).
However, from month to month, the telehealth share of medical claim lines fell 16.5% nationally from 6.07% in August 2020 to 5.07 percent in September 2020. The data represent the privately insured population, excluding Medicare and Medicaid.
Trends in the 4 US census regions (Midwest, Northeast, South and West) were similar to those in the nation as a whole. In each region, there were large percent increases in volume of claim lines from September 2019 to September 2020, but relatively small decreases from August 2020 to September 2020.
Higher telehealth utilization from March to September 2020 in comparison with the same months in 2019 was likely a result of the COVID-19 pandemic. In March and April 2020, many states prohibited in-person rendering of elective procedures, making telehealth a viable alternative. Many of these prohibitions expired in May as states began to open up. But despite some decline from month to month, telehealth usage remained high in comparison to 2019, as the pandemic continued.
Another notable finding of the September Monthly Telehealth Regional Tracker concerns the top 5 telehealth diagnoses by volume. Mental health conditions, the number one telehealth diagnosis nationally and in every region since March 2020, continued to rise in every region as a share of all telehealth diagnoses, growing nationally from 48.93% in August 2020 to 51.83% in September 2020.
The trend toward increased delivery of mental health services via telehealth was also apparent in the top telehealth procedure codes by utilization. In the Northeast, CPT® 99213, a 15-minute established patient office visit, was the number 1 procedure code in August 2020, followed by 2 psychotherapy codes, CPT 90834 (45 minutes) and CPT 90837 (60 minutes). In September 2020, CPT 90834 and CPT 90837 rose to number 1 and 2, respectively, while CPT 99213 fell to number 3 (Figure 2).
Also of note, from August to September 2020, substance use disorders rose from the number five telehealth diagnosis in the Northeast to the number four rank. This is consistent with an increase in mental health conditions and substance use disorders that has been noted during the COVID-19 pandemic by the Centers for Disease Control and Prevention and others.
About the Monthly Telehealth Regional Tracker
Launched in May as a free service, the Monthly Telehealth Regional Tracker uses FAIR Health data to track how telehealth is evolving from month to month. An interactive map of the four US census regions allows the user to view an infographic on telehealth in a specific month in the nation as a whole or in individual regions. In addition to data on the volume of claim lines, diagnoses and procedure codes, each infographic includes findings on urban versus rural usage.
Telehealth has persisted in showing high utilization across the country throughout the COVID-19 pandemic. FAIR Health’s Monthly Telehealth Regional Tracker will continue to provide insights into the evolution of this venue of care.
For the Monthly Telehealth Regional Tracker, click here.
Robin Gelburd, JD, is the President of FAIR Health, a national, independent nonprofit organization with the mission of bringing transparency to healthcare costs and health insurance information. FAIR Health possesses the nation’s largest collection of private healthcare claims data, which includes over 32 billion claim records and is growing at a rate of over 2 billion claim records a year. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D; FAIR Health includes among the private claims data in its database, data on Medicare Advantage enrollees. Ms. Gelburd is a nationally recognized expert on healthcare policy, data and transparency.